| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
22,198 |
22,175 |
$704K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
2,308 |
2,298 |
$283K |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
584 |
558 |
$169K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,914 |
3,907 |
$118K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
3,185 |
3,174 |
$108K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
1,101 |
1,084 |
$95K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
7,300 |
7,263 |
$78K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,179 |
1,172 |
$63K |
| E0570 |
Nebulizer, with compressor |
5,594 |
5,572 |
$60K |
| K0001 |
Standard wheelchair |
4,318 |
4,301 |
$57K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
1,087 |
1,085 |
$46K |
| E1392 |
Portable oxygen concentrator, rental |
6,403 |
6,399 |
$41K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,378 |
1,374 |
$40K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,381 |
6,370 |
$40K |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
2,435 |
2,432 |
$36K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
1,346 |
1,342 |
$34K |
| K0003 |
Lightweight wheelchair |
1,529 |
1,521 |
$33K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,253 |
1,243 |
$31K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
320 |
308 |
$31K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
814 |
782 |
$29K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
247 |
234 |
$24K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,008 |
1,006 |
$24K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
930 |
928 |
$20K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
266 |
253 |
$20K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
720 |
716 |
$16K |
| A7035 |
Headgear used with positive airway pressure device |
1,492 |
1,487 |
$11K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,989 |
1,987 |
$11K |
| E0607 |
Home blood glucose monitor |
259 |
257 |
$10K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
637 |
635 |
$9K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
196 |
196 |
$9K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
253 |
252 |
$8K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,623 |
2,473 |
$8K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,508 |
1,503 |
$8K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
672 |
670 |
$7K |
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
43 |
42 |
$6K |
| B9002 |
Enteral nutrition infusion pump, any type |
154 |
150 |
$5K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
41 |
41 |
$4K |
| A4259 |
Lancets, per box of 100 |
681 |
659 |
$4K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
115 |
112 |
$3K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
133 |
132 |
$3K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,021 |
1,021 |
$2K |
| A7037 |
Tubing used with positive airway pressure device |
113 |
113 |
$2K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
47 |
40 |
$2K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
69 |
68 |
$1K |
| E0776 |
Iv pole |
231 |
218 |
$1K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
57 |
56 |
$987.18 |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
12 |
12 |
$705.01 |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
38 |
38 |
$628.94 |
| E0256 |
Hospital bed, variable height, hi-lo, with any type side rails, without mattress |
26 |
25 |
$586.32 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
109 |
108 |
$487.57 |
| A4456 |
Adhesive remover, wipes, any type, each |
119 |
112 |
$424.46 |
| E0156 |
Seat attachment, walker |
55 |
55 |
$323.21 |
| A5120 |
Skin barrier, wipes or swabs, each |
67 |
66 |
$268.92 |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
14 |
14 |
$91.47 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
193 |
193 |
$85.58 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
477 |
476 |
$17.27 |